Understanding geographic variation in Healthcare

The Atlas of Healthcare Variation presents 21 maps highlighting geographic differences across the 18 districts of mainland Portugal for a set of indicators related to hospital admissions and procedures.

This work is not a ranking of hospital or service quality. Instead, it is a tool to help identify and question variations in healthcare outcomes among resident populations in different regions. This work had the help of Professor Sir Muir Gray, who inspired us on the importance of analyzing variation as a source of potential low-value healthcare.

Variations may reflect:

  • Differences in disease prevalence;
  • Possible inefficient or excessive use of healthcare resources;
  • Potential inequities in access, including gaps in health literacy.

The Atlas encourages both the public and healthcare decision-makers to explore these questions and promote further research into their causes.

Project partners

Project goals

  1. Map and visualize geographic variation in healthcare indicators across Portugal.
  2. Promote open access to data and evidence for public discussion and policymaking.
  3. Encourage the health system to ask critical questions about equity, efficiency, and access.
  4. Support the principles of Open Science by making findings available to all.

Our role

This project reflects VOH.CoLAB’s commitment to innovation in health systems and the values of open, collaborative science. We coordinated the design and development of the Atlas, ensuring:

  • Scientifically grounded, clearly presented visual health data;
  • Focus on equity, transparency, and accessibility for diverse audiences;
  • Alignment with EU Open Science principles, making the content freely available to society.

Lead researcher at VOH

Ana Rita Londral, PhD

Executive Director

Project outcomes and impact

  • A publicly available Healthcare Variation Atlas with 21 maps illustrating differences across Portuguese districts.
  • Greater awareness of geographic inequalities in healthcare delivery and outcomes.
  • A tool for citizens, researchers, and policymakers to ask better questions and investigate causes of variation.
  • A practical example of scientific knowledge that was translated into accessible knowledge for the general population.

Publications

  • von Hafe, F., Azevedo, S., Fragata, J., & Londral, A. (2023). Initial steps for the Portuguese Atlas of geographical variation in healthcare. Research in Health Services & Regions, 2(7). https://doi.org/10.1007/s43999-023-00022-w